Individual
DR. CLAY H WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
820 ST. SEBASTIAN WAY, SUITE 8A, AUGUSTA, GA 30901
(706) 722-6900
(706) 722-5118
Mailing address
820 ST. SEBASTIAN WAY, SUITE 8A, AUGUSTA, GA 30901
(706) 722-6900
(706) 722-5118
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
043510
GA
207RN0300X
Nephrology Physician
13568
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000749911A
—
GA
05
—
000749911AB
—
GA
05
—
000749911AC
—
GA
05
—
000749911AD
—
GA
05
—
000749911AE
—
GA
05
—
000749911AF
—
GA
05
—
000749911AG
—
GA
05
—
000749911AH
—
GA
05
—
000749911AI
—
GA
05
—
000749911K
—
GA
05
—
000749911M
—
GA
05
—
000749911P
—
GA
05
—
000951915B
—
GA
05
—
000951915C
—
GA
05
—
000951915E
—
GA
01
—
10058037
AMERIGROUP
GA
01
—
1134106925
BCBS-GA
GA
01
—
338224
WELLCARE OF GA
GA
01
—
390005010
RAILROAD MEDICARE
GA
05
—
G43510
—
SC
Enumeration date
12/22/2005
Last updated
11/05/2014
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